Health & Fitness

How Maryland's Health System Ranks In The U.S.

A new report from the Commonwealth Fund evaluates the performance of each state's health system. Here's how Maryland ranks.

Maryland's health system ranks among the top 20 states in the U.S., a new report says.
Maryland's health system ranks among the top 20 states in the U.S., a new report says. (Shutterstock)

Maryland's health system ranks among the top 20 in the United States, according to a new report that assesses performance in all 50 states and the District of Columbia. The state was ranked at No. 18 among all states.

Overall, the report from the Commonwealth Fund drew three principal conclusions based on the results of individual states’ performance. While deaths from suicide, drugs and alcohol, known together as “deaths of despair,” affect the entire country and contribute to the decline in life expectancy, the impact of this national crisis varies in every state. In Maryland, which has been hit hard by the opioid epidemic, there are signs that efforts to curb opioid overdoses seem to be working, based upon the 2019 first quarter figures released by the Maryland Department of Health and the Opioid Operational Command Center. During the first three months of 2019, there were 577 total overdose deaths, a 15 percent decrease from the same period in 2018.

The Commonwealth Fund report also found that gains made in lowering the uninsured rates following the passage of the Affordable Care Act have stalled and in some cases have even begun to erode.

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And finally, the report says that high health care costs are driving up premium costs for private plans, leaving people with high deductibles and out-of-pocket expenses.

States were evaluated on 47 performance indicators that were grouped into four categories. Here’s how Maryland ranked across the four categories evaluated in the report:

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  • Access and Affordability: 14
  • Prevention and Treatment: 11
  • Potentially Avoidable Hospital Use and Cost: 20
  • Healthy Lives: 25

Deaths From Drugs, Alcohol, Suicide

The opioid epidemic in New England, the Mid-Atlantic and several Southeast states has led to higher rates of death from drug overdoses in these regions. According to the report, West Virginia, Ohio, Pennsylvania, D.C., Kentucky, Delaware and New Hampshire have the highest death rates from drug overdoses.

Every local jurisdiction in Maryland except Dorchester, Garrett and Somerset counties, had opioid-related fatalities in the first quarter of 2019. Baltimore City, Baltimore County and Anne Arundel County experienced the highest number of fatalities, which collectively accounted for 66.2 percent of all opioid-related deaths in Maryland in the first quarter of 2019.

"We've seen a decrease in deaths during this first quarter and continue to work diligently to combat this epidemic," said Maryland Department of Health Secretary Robert R. Neall in a statement. "Treatment and prevention options are available 24/7 for those who want it. They can dial 211 and press 1 to find assistance. Our goal is to get support to everyone who needs help as soon as possible."

According to the state, fentanyl continues to be the deadliest substance, with 474 fentanyl-related deaths occurring in the first quarter alone, an eight percent decrease from the same time period last year. Fentanyl was involved in 92 percent of opioid-related deaths during this period.

Conversely, in Montana, Nebraska, the Dakotas, Oregon and Wyoming, there were higher rates of death from suicide and alcohol than from drugs. The report found that in 13 other states, there were more deaths from either suicide or alcohol than from drug overdoses.

Between 2005 and 2017, the death rate from drug overdoses more than doubled in the country, the report says. Suicide rates increased nearly 30 percent since 2005 and the deaths from alcohol rose an average of four percent each year between 2013 and 2017.

In all 50 states, deaths from these three causes increased at least 3 percent between 2005 and 2017.

A previous report published by two different groups in March found that these so-called “deaths of despair” reached a record high in 2017. Figures published in that report showed that more than 150,000 people died from these three causes in 2017, a number that more than doubled since 1999.

Uninsured Rates

The Commonwealth Fund found that rather than building on the reductions in the uninsured rate following the Affordable Care Act, more than half of the states just held on to these gains between 2016 and 2017. And in 16 states, including those that did not expand Medicaid, there were increases of a single percentage point in uninsured rates, the report says.

The uninsured rate was the lowest in Massachusetts and the highest in Texas.

Medicaid expansion has a big role to play for the uninsured rates in states, the report says. Five of the states with the highest uninsured rates are among the 17 states that have yet to expand Medicaid, according to the report.

Three states that recently expanded Medicaid — Alaska, Louisiana and Montana — all saw decreases in the uninsured rate among low-income adults between 2016 and 2017.

Rising Premiums

For Americans covered by health plans provided by their employers, the amount they contribute to those plans is rising faster than the median income in most states, the report says.

The rising costs of these plans is leaving people with high deductibles and out-of-pocket costs, according to the report. At the end of 2018, 44 million people were considered underinsured because their deductibles and out-of-pocket costs were so high.

You can read the full report here.


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